Topic in Geriatrics: Tai chi in Older Adults and its benefit in decreasing fall risk
Tai Chi originated in China and is now used widely around the United States. This form of exercise is known to be an art that has both physical and psychological benefits. It continues to grow in its use for the elderly, 65 and older, to address the decline in balance with age. This form of exercise has movements that emphasize weight transference that helps to improve balance and prevent falls.
Objectives
What is a fall? Who falls?
What is Tai-chi?
Why Tai chi?
Tai Chi effects on balance in older adults (according to evidence)
How Physical Therapist can get more individuals involved in Tai Chi
Suggestions for how to incorporate Tai chi into Physical therapy
What is a fall and who falls?
With age, balance becomes a big problem resulting in falls especially in the elderly. “Falls are the leading cause of injury in older adults” (Leung, Chan, H. Tsang, W. Tsang, & Jones, 2011). A fall is defined as “inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest on furniture, wall, or other objects, according to the World Health Organization (Leung et. al., 2011). Falls are becoming an epidemic in older adults and prevention is important in order to prevent hospitalization, increasing medical cost, or secondary death from complication that can result from surgeries that may result from a fall.
What is Tai-chi?
Tai Chi is a form of martial art that uses slow and continuous but highly choreographed movements that involves both unilateral and bilateral weight shifts as well as trunk control and extremity rotation. It is characterized by deep breathing and slow movements focused on controlling the central balance of the body (Gryffin, Chen, Chaney, Dodd, & Roberts, 2015). There are five different styles: Chen, Yang, Wu/Hao, Wu, and Sun. Each style is based upon the same principle of using muscle relaxation in generating leverage. Tai chi is believed to improve energy within the body as well as health of the individuals. During tai chi, individuals usually do not exceed 55% of their maximum oxygen uptake and 60% of their maximum heart rate. These properties make this form of exercise a moderate-intensity exercise.
Why Tai- chi?
There are many exercise options that individuals of all ages can participate in. Senior citizens have many options of their own such as various seated exercise classes like sittercise, silver sneakers, Yoga for older adults and various aquatic exercise programs. So one may ask why Tai Chi?
Tai chi is a gentle option
Its flow and focus on breathing provides opportunity to individuals to quiet their mind and detach from stresses
Improves hand-eye coordination
Contributes to a sense of well-being which is beneficial in seniors, a population prone to depression
Effective tool in fall prevention
Easily accessible
Low impact
Tai-chi and its Effects on Balance in Older Adults (according to Evidence)
There continues to be an abundant amount of research on balance impairments in the older adults and various prevention measures that can be implemented into their everyday schedules. Tai Chi is a prevention measure that is becoming more popular around the world, not only in those older than 65, but the younger populations as well. There have been many studies completed on the effects that Tai chi has in reducing fall risk in older adults. Several studies were referenced in Leung et al, (2011), and many had various findings such as Li et al found that “the number of falls were reduced in a tai chi group compared to the exercise stretching group”, Voukelatos et al reported a “50% relative risk reduction of two or more falls among those who participated in the tai chi group compared to a control group that received no treatment”, Wolf et al demonstrated a “decrease in the number of falls over time among participants in both a tai chi and a wellness education group”, and Woo et al was the only study referenced in this particular article that showed “no significant difference in the number of falls between those who practiced tai chi, did resistance exercise, and received no treatment”.
How Physical Therapist can get more people involved in Tai chi
Tai chi is becoming more widely used in communities and local gyms. There are also many Tai chi instructors who have various other careers. Debi Benjamin is a physical therapist assistant who is also a Tai chi instructor. She has utilized her certification in Tai chi to complement her health and fitness background. In an article that she wrote in 2006, she states, “teaching tai chi has sharpened my ability to break down complex movements into incremental teachable, goal-driven components”. She does not always use the exact movements of Tai chi during her treatments but she implements the principles of the martial art to correct movement, body mechanics, and posture. This in turn has led to many of her patients continuing Tai Chi upon discharge from the clinic.
This is a way that Physical Therapist and assistants can get more people involved in this form of exercise, by introducing it and its principles in the clinic, applying it to our patients, and leaving them with additional information about this form of martial art in hopes that they will continue with it upon discharge for their own health benefits. According to Benjamin (2006), the use of Tai Chi in physical therapy is evidenced based. She also states its association with improved balance and strength in senior citizens and its link to reduced fall risk in that population.
Suggestions for how to incorporate Tai Chi into Physical Therapy practice
Utilize tai chi relaxation techniques at the beginning of treatment session
Demonstrate and use correct posture throughout treatment and then use breathing techniques plus mind coordination and awareness to focus on increasing flexibility as well as strength
Perform flowing movement outside of patients base of support and center of mass
Incorporate slow movements into single leg stance positions as well as into transitional movements
Progress movements to become more functional such as getting up off the floor, stepping on and over objects etc.
Leung D, Chan C, Tsang H, Tsang W, Jones A. Tai chi as an intervention to improve balance and reduce falls in older adults: A systematic and meta-analytical review. Alternative Therapies In Health & Medicine [serial online]. January 2011;17(1):40-48 9p. Available from: CINAHL Complete, Ipswich, MA. Accessed May 12, 2016.
Gryffin P, Chen W, Chaney B, Dodd V, Roberts B. Facilitators and Barriers to Tai Chi in an Older Adult Community: A Theory-Driven Approach. American Journal Of Health Education [serial online]. March 2015;46(2):109-118 10p. Available from: CINAHL Complete, Ipswich, MA. Accessed May 12, 2016.
Benjamin D. Physical therapy, physical fitness, and tai chi. PT: Magazine Of Physical Therapy [serial online]. November 2006;14(11):34-35 2p. Available from: CINAHL Complete, Ipswich, MA. Accessed May 12, 2016.
Topic in Geriatrics: Tai chi in Older Adults and its benefit in decreasing fall risk
Tai Chi originated in China and is now used widely around the United States. This form of exercise is known to be an art that has both physical and psychological benefits. It continues to grow in its use for the elderly, 65 and older, to address the decline in balance with age. This form of exercise has movements that emphasize weight transference that helps to improve balance and prevent falls.
Objectives
What is a fall and who falls?
With age, balance becomes a big problem resulting in falls especially in the elderly. “Falls are the leading cause of injury in older adults” (Leung, Chan, H. Tsang, W. Tsang, & Jones, 2011). A fall is defined as “inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest on furniture, wall, or other objects, according to the World Health Organization (Leung et. al., 2011). Falls are becoming an epidemic in older adults and prevention is important in order to prevent hospitalization, increasing medical cost, or secondary death from complication that can result from surgeries that may result from a fall.
What is Tai-chi?
Tai Chi is a form of martial art that uses slow and continuous but highly choreographed movements that involves both unilateral and bilateral weight shifts as well as trunk control and extremity rotation. It is characterized by deep breathing and slow movements focused on controlling the central balance of the body (Gryffin, Chen, Chaney, Dodd, & Roberts, 2015). There are five different styles: Chen, Yang, Wu/Hao, Wu, and Sun. Each style is based upon the same principle of using muscle relaxation in generating leverage. Tai chi is believed to improve energy within the body as well as health of the individuals. During tai chi, individuals usually do not exceed 55% of their maximum oxygen uptake and 60% of their maximum heart rate. These properties make this form of exercise a moderate-intensity exercise.
Why Tai- chi?
There are many exercise options that individuals of all ages can participate in. Senior citizens have many options of their own such as various seated exercise classes like sittercise, silver sneakers, Yoga for older adults and various aquatic exercise programs. So one may ask why Tai Chi?
Tai-chi and its Effects on Balance in Older Adults (according to Evidence)
There continues to be an abundant amount of research on balance impairments in the older adults and various prevention measures that can be implemented into their everyday schedules. Tai Chi is a prevention measure that is becoming more popular around the world, not only in those older than 65, but the younger populations as well. There have been many studies completed on the effects that Tai chi has in reducing fall risk in older adults. Several studies were referenced in Leung et al, (2011), and many had various findings such as Li et al found that “the number of falls were reduced in a tai chi group compared to the exercise stretching group”, Voukelatos et al reported a “50% relative risk reduction of two or more falls among those who participated in the tai chi group compared to a control group that received no treatment”, Wolf et al demonstrated a “decrease in the number of falls over time among participants in both a tai chi and a wellness education group”, and Woo et al was the only study referenced in this particular article that showed “no significant difference in the number of falls between those who practiced tai chi, did resistance exercise, and received no treatment”.
How Physical Therapist can get more people involved in Tai chi
Tai chi is becoming more widely used in communities and local gyms. There are also many Tai chi instructors who have various other careers. Debi Benjamin is a physical therapist assistant who is also a Tai chi instructor. She has utilized her certification in Tai chi to complement her health and fitness background. In an article that she wrote in 2006, she states, “teaching tai chi has sharpened my ability to break down complex movements into incremental teachable, goal-driven components”. She does not always use the exact movements of Tai chi during her treatments but she implements the principles of the martial art to correct movement, body mechanics, and posture. This in turn has led to many of her patients continuing Tai Chi upon discharge from the clinic.
This is a way that Physical Therapist and assistants can get more people involved in this form of exercise, by introducing it and its principles in the clinic, applying it to our patients, and leaving them with additional information about this form of martial art in hopes that they will continue with it upon discharge for their own health benefits. According to Benjamin (2006), the use of Tai Chi in physical therapy is evidenced based. She also states its association with improved balance and strength in senior citizens and its link to reduced fall risk in that population.
Suggestions for how to incorporate Tai Chi into Physical Therapy practice
Resources
1. **http://taichiforhealthinstitute.org**
2. **http://www.trustpointhospital.com/index.php/2015/06/26/benefits-tai-chi-senior-citizens/**
3. **http://taichiforseniorsvideo.com/seniors**
4. **http://www.taichi4therapy.com**
5.http://vestibular.org/sites/default/files/page_files/Improving%20Balance%20With%20Tai%20Chi_2.pdf
6. http://www.taichimovingforbetterbalance.org/tai-chi-the-pt-continuing-competence-credit-course/
References